HL7 Europe Hospital Discharge Report
1.0.0-alpha - qa-preview 150

HL7 Europe Hospital Discharge Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 1.0.0-alpha built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/hdr/ and changes regularly. See the Directory of published versions

## Resource Profile: CompositionEuHdr - Detailed Descriptions

Draft as of 2026-04-17

Definitions for the composition-eu-hdr resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

Guidance on how to interpret the contents of this table can be foundhere

0. Composition
Definition | Hospital Discharge Report composition. A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained. A set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.).
Short | Hospital Discharge Report compositionA set of resources composed into a single coherent clinical statement with clinical attestation
Comments | While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.
Control | 0..*
Is Modifier | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) text-or-section: A Composition SHALL have either text, at least one section, or both. (`text.exists() or section.exists()`)
2. Composition.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Composition.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Composition.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
6. Composition.extension:basedOn
Slice Name | basedOn
Definition | A plan, proposal or order that is fulfilled in whole or in part by this event.
Short | Fulfills plan, proposal or order
Control | 0..*
Type | Extension(Based on) (Extension Type: Reference(Resource))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Composition.extension:basedOn.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Composition.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
10. Composition.extension:basedOn.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/StructureDefinition/event-basedOn`
12. Composition.extension:basedOn.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 10..1 This element is affected by the following invariants: ext-1
Type | Reference(Resource, ServiceRequest), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Composition.extension:version
Slice Name | version
Definition | This cross-version extension represents Composition.version from http://hl7.org/fhir/StructureDefinition/Composition|5.0.0 for use in FHIR R4.
Short | Business version
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Cross-version Extension for R5.Composition.version for use in FHIR R4) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
16. Composition.extension:information-recipient
Slice Name | information-recipient
Definition | This extension applies to the Composition resource and is used to represent an intended recipient of the composition.
Short | Composition: Information recipient
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Composition: Information recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization, CareTeam, Group))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. Composition.extension:information-recipient.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Composition.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
20. Composition.extension:information-recipient.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.eu/fhir/StructureDefinition/information-recipient`
22. Composition.extension:information-recipient.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..1
Type | Reference(PractitionerRole (EU core), Practitioner (EU core), Device, Patient (EU core), RelatedPerson, Organization (EU core)), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Composition.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
26. Composition.identifier
Definition | A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.
Short | HDR business identifierVersion-independent identifier for the Composition
Comments | Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Composition.status
Definition | The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.
Short | HDR statuspreliminary | final | amended | entered-in-error
Comments | If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements. Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.
Control | 1..1
Binding | The codes SHALL be taken from CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/composition-status|4.0.1` ) The workflow/clinical status of the composition.
Type | code
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be able to mark interim, amended, or withdrawn compositions or documents.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Composition.type
Definition | Specifies that this composition refer to a Hospital Discharge Report Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.
Short | Kind of composition ("Hospital Discharge Report")Kind of composition (LOINC if possible)
Comments | For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.
Control | 1..1
Binding | The codes SHOULD be taken from FHIRDocumentTypeCodes http://hl7.org/fhir/ValueSet/doc-typecodes|4.0.1 (preferred to `http://hl7.org/fhir/ValueSet/doc-typecodes|4.0.1` ) Type of a composition.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | true
Requirements | Key metadata element describing the composition, used in searching/filtering.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "34105-7", "display" : "Hospital Discharge summary" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. Composition.subject
Definition | Who or what the composition is about. In general a composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure). For the hdr the subject is always the patient. Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).
Short | Who and/or what the composition is about
Comments | For clinical documents, this is usually the patient.
Control | 10..1
Type | Reference(Patient (EU core), Resource)
Is Modifier | false
Summary | true
Requirements | Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. Composition.encounter
Definition | Describes the clinical encounter or type of care this documentation is associated with.
Short | Context of the Composition
Control | 0..1
Type | Reference(Encounter (HDR), Encounter)
Is Modifier | false
Summary | true
Requirements | Provides context for the composition and supports searching.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. Composition.date
Definition | The composition editing time, when the composition was last logically changed by the author.
Short | HDR dateComposition editing time
Comments | The Last Modified Date on the composition may be after the date of the document was attested without being changed.
Control | 1..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging. dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. Composition.author
Definition | Identifies who is responsible for the information in the Hospital Discharge Report, not necessarily who typed it in. Identifies who is responsible for the information in the composition, not necessarily who typed it in.
Short | Who and/or what authored the Hospital Discharge ReportWho and/or what authored the composition
Control | 1..*
Type | Reference(Practitioner (EU core), PractitionerRole (EU core), Device, Organization (EU core), Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | true
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Composition.title
Definition | Official human-readable label for the composition. For this document should be "Hospital Discharge Report" or any equivalent translation Official human-readable label for the composition.
Short | Hospital Discharge ReportHuman Readable name/title
Comments | For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. Composition.section
Definition | The root of the sections that make up the HDR composition. The root of the sections that make up the composition.
Short | Sections composing the HDRComposition is broken into sections
Control | 10..*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
Slicing | This element introduces a set of slices on `Composition.section`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ code
44. Composition.section.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
46. Composition.section.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
48. Composition.section.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
50. Composition.section.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. Composition.section.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. Composition.section:sectionAdmissionEvaluation
Slice Name | sectionAdmissionEvaluation
Definition | Hospital Admission evaluation The root of the sections that make up the composition.
Short | Hospital Admission evaluationComposition is broken into sections
Comments | Admission evaluation should be reported only exceptionally, if it is relevant to ensure continuity of care.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
56. Composition.section:sectionAdmissionEvaluation.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
58. Composition.section:sectionAdmissionEvaluation.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
60. Composition.section:sectionAdmissionEvaluation.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. Composition.section:sectionAdmissionEvaluation.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "67851-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. Composition.section:sectionVitalSigns
Slice Name | sectionVitalSigns
Definition | The Vital signs section includes blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included The root of the sections that make up the composition.
Short | Vital signsComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
66. Composition.section:sectionVitalSigns.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
68. Composition.section:sectionVitalSigns.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
70. Composition.section:sectionVitalSigns.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. Composition.section:sectionVitalSigns.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "8716-3" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. Composition.section:sectionVitalSigns.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation, DocumentReference, Vital Signs Profile, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
76. Composition.section:sectionPhysicalFindings
Slice Name | sectionPhysicalFindings
Definition | Physical findings The root of the sections that make up the composition.
Short | Physical findingsComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
78. Composition.section:sectionPhysicalFindings.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
80. Composition.section:sectionPhysicalFindings.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
82. Composition.section:sectionPhysicalFindings.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. Composition.section:sectionPhysicalFindings.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "29545-1" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
86. Composition.section:sectionFunctionalStatus
Slice Name | sectionFunctionalStatus
Definition | The functional status section shall contain a narrative description of capability of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide. The root of the sections that make up the composition.
Short | Functional statusComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
88. Composition.section:sectionFunctionalStatus.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
90. Composition.section:sectionFunctionalStatus.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
92. Composition.section:sectionFunctionalStatus.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
94. Composition.section:sectionFunctionalStatus.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "47420-5" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
96. Composition.section:sectionFunctionalStatus.entry
Definition | It describes capabilities of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide. A reference to the actual resource from which the narrative in the section is derived.
Short | Optional entry used to represent disabilities and functional assessmentsA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Condition, ClinicalImpression, Observation, DocumentReference, QuestionnaireResponse, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
98. Composition.section:sectionHospitalCourse
Slice Name | sectionHospitalCourse
Definition | This section includes basic information about hospital staty (encounter), diagnostic summary in narrative form, pharmacotherapy, major procedures, medical devices, significant findings during hospital stay and clinical synthesis. The root of the sections that make up the composition.
Short | Significant information about course of hospital stayComposition is broken into sections
Control | 10..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
100. Composition.section:sectionHospitalCourse.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
102. Composition.section:sectionHospitalCourse.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
104. Composition.section:sectionHospitalCourse.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
106. Composition.section:sectionHospitalCourse.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "8648-8" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
108. Composition.section:sectionDiagnosticSummary
Slice Name | sectionDiagnosticSummary
Definition | All problems/diagnoses that affect care during the inpatient case or are important to be recorded to ensure continuity of care. The diagnostic summary differentiates, in accordance with the international recommendation, between problems treated during hospital stay and other (untreated) problems. Treated problems are problems that were the subject of diagnostics, therapy, nursing, or (continuous) monitoring during the hospitalisation. Furthermore problems could be divided into three categories: problems present on admission (POA), conditions acquired during hospital stay (HAC) and problems that cannot be classified as being of any of the two (N/A). The diagnostic summary contains all conditions as they were recognised at the end of hospitalisation, after all examinations. This section contains concise, well specified, codeable, summary of problems. Problems are ordered by importance (main problems first) during hospital stay. Description of the problem might be completed with additional details in the medical history section and/or in the Synthesis section. The root of the sections that make up the composition.
Short | Problem specification in narrative formComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
110. Composition.section:sectionDiagnosticSummary.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
112. Composition.section:sectionDiagnosticSummary.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
114. Composition.section:sectionDiagnosticSummary.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
116. Composition.section:sectionDiagnosticSummary.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11535-2" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
118. Composition.section:sectionDiagnosticSummary.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Condition (EU core), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
120. Composition.section:sectionSignificantProcedures
Slice Name | sectionSignificantProcedures
Definition | Significant surgical and non-surgical procedures performed during hospitalisation which are significant for continuity of care, e.g. surgeries and other "instrumental"interventions (endoscopic, intravascular), chemotherapy, radiotherapy, purification methods (dialysis, hemoperfusion), circulation support methods (counterpulsation, etc.), administration of blood derivatives or others. This section does not include purely diagnostic procedures (MRI, CT, etc.). If no significant performance has been performed, this fact must be explicitly stated using the IPS Absent and Unknown Data. The root of the sections that make up the composition.
Short | Significant proceduresComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
122. Composition.section:sectionSignificantProcedures.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
124. Composition.section:sectionSignificantProcedures.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
126. Composition.section:sectionSignificantProcedures.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
128. Composition.section:sectionSignificantProcedures.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "10185-7" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
130. Composition.section:sectionSignificantProcedures.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Procedure (EU core), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
132. Composition.section:sectionSignificantProcedures.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
134. Composition.section:sectionMedicalDevices
Slice Name | sectionMedicalDevices
Definition | Implants and used medical devices that affected or may affect the provision of health services (diagnosis and treatment). Also medical devices explanted, or its use was stopped during hospitalisation. If the section is blank, the reason must be explicitly stated using the IPS Absent and Unknown Data coding system. The root of the sections that make up the composition.
Short | Medical devices and implantsComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
136. Composition.section:sectionMedicalDevices.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
138. Composition.section:sectionMedicalDevices.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
140. Composition.section:sectionMedicalDevices.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
142. Composition.section:sectionMedicalDevices.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "57080-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
144. Composition.section:sectionMedicalDevices.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(DeviceUseStatement (HDR), Procedure (EU core), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
146. Composition.section:sectionMedicalDevices.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
148. Composition.section:sectionPharmacotherapy
Slice Name | sectionPharmacotherapy
Definition | Selected drug treatment during hospitalisation. Medicinal products that were administered during hospitalisation and whose administration has already been discontinued before discharge. Only products which are important for continuity of care (antibiotics other than completely routine, corticosteroids in high doses, etc.) will be listed. Products which administration will continue after discharge will be also recorder in the Medication summary section. Medicinal products, the administration of which was started during hospitalisation but is also recommended after discharge, will be listed in the summary table in the recommendation section. The root of the sections that make up the composition.
Short | PharmacotherapyComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
150. Composition.section:sectionPharmacotherapy.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
152. Composition.section:sectionPharmacotherapy.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
154. Composition.section:sectionPharmacotherapy.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
156. Composition.section:sectionPharmacotherapy.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "87232-5" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
158. Composition.section:sectionPharmacotherapy.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(MedicationStatement (EU core), MedicationRequest (HDR), MedicationDispense (HDR), MedicationAdministration (HDR), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
160. Composition.section:sectionSignificantResults
Slice Name | sectionSignificantResults
Definition | Significant medical test results of functional, diagnostic (including laboratory), and imaging examinations performed during encounter. This may include orders for which the results have not yet arrived. The root of the sections that make up the composition.
Short | Significant medical test resultsComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
162. Composition.section:sectionSignificantResults.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
164. Composition.section:sectionSignificantResults.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
166. Composition.section:sectionSignificantResults.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
168. Composition.section:sectionSignificantResults.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "30954-2" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
170. Composition.section:sectionSignificantResults.entry
Definition | Significant medical test results slice A reference to the actual resource from which the narrative in the section is derived.
Short | Significant medical test resultsA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation, DiagnosticReport, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
172. Composition.section:sectionSignificantResults.entry:results-medicalTestResult
Slice Name | results-medicalTestResult
Definition | Results collected on the patient or produced on in-vitro biologic specimens. A reference to the actual resource from which the narrative in the section is derived.
Short | Medical test resultsA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation: Medical Test Result (EU core), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
174. Composition.section:sectionSignificantResults.entry:results-diagnosticReport
Slice Name | results-diagnosticReport
Definition | DiagnosticReport resource to represent diagnostic test and procedure reports in a patient summary A reference to the actual resource from which the narrative in the section is derived.
Short | DiagnosticReportA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(DiagnosticReport (EU core), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
176. Composition.section:sectionSynthesis
Slice Name | sectionSynthesis
Definition | This section provides clinical synthesis (e.g. description of reasons and course of hospital stay) clustered by managed conditions. Clinical synthesis may include clinical reasoning (differential diagnostics, explanation of clinical context) in clinically complex conditions. The root of the sections that make up the composition.
Short | SynthesisComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
178. Composition.section:sectionSynthesis.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
180. Composition.section:sectionSynthesis.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
182. Composition.section:sectionSynthesis.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
184. Composition.section:sectionSynthesis.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "67781-5" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
186. Composition.section:sectionPlanOfCare
Slice Name | sectionPlanOfCare
Definition | The plan of care section contains a narrative description of the expectations for care including proposals, goals, and order requests for monitoring, tracking, or improving the condition of the patient. The root of the sections that make up the composition.
Short | Plan of Care SectionComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
188. Composition.section:sectionPlanOfCare.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
190. Composition.section:sectionPlanOfCare.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
192. Composition.section:sectionPlanOfCare.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
194. Composition.section:sectionPlanOfCare.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "18776-5" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
196. Composition.section:sectionPlanOfCare.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Care Plan (HDR), DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
198. Composition.section:sectionDischargeInstructions
Slice Name | sectionDischargeInstructions
Definition | Hospital Discharge Instructions The root of the sections that make up the composition.
Short | Hospital Discharge InstructionsComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
200. Composition.section:sectionDischargeInstructions.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
202. Composition.section:sectionDischargeInstructions.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
204. Composition.section:sectionDischargeInstructions.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
206. Composition.section:sectionDischargeInstructions.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "8653-8" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
208. Composition.section:sectionDischargeMedications
Slice Name | sectionDischargeMedications
Definition | Hospital discharge medications defines the medications that the patient is intended to take, or stop, after discharge The root of the sections that make up the composition.
Short | Hospital discharge medicationsComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
210. Composition.section:sectionDischargeMedications.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
212. Composition.section:sectionDischargeMedications.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
214. Composition.section:sectionDischargeMedications.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
216. Composition.section:sectionDischargeMedications.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "75311-1" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
218. Composition.section:sectionDischargeMedications.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(MedicationRequest (HDR), MedicationDispense (HDR), MedicationStatement (EU core), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
220. Composition.section:sectionAllergies
Slice Name | sectionAllergies
Definition | This section documents the relevant allergies or intolerances for that patient, describing the kind of reaction - e.g. rash, anaphylaxis,.. - preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. If no information about allergies is available, or if no allergies are known this should be clearly documented in the section. The root of the sections that make up the composition.
Short | Allergies and Intolerances SectionComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
222. Composition.section:sectionAllergies.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
224. Composition.section:sectionAllergies.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
226. Composition.section:sectionAllergies.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
228. Composition.section:sectionAllergies.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48765-2" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
230. Composition.section:sectionAllergies.entry
Definition | allergyOrIntolerance A reference to the actual resource from which the narrative in the section is derived.
Short | allergyOrIntoleranceA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(AllergyIntolerance, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
232. Composition.section:sectionAllergies.entry:allergyOrIntolerance
Slice Name | allergyOrIntolerance
Definition | It lists the relevant allergies or intolerances for that patient, describing the kind of reaction - e.g. rash, anaphylaxis,.. - preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. If no information about allergies is available, or if no allergies are known this should be clearly documented in the section. A reference to the actual resource from which the narrative in the section is derived.
Short | Relevant allergies or intolerances for that patient.A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(AllergyIntolerance (EU core), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
234. Composition.section:sectionAlert
Slice Name | sectionAlert
Definition | // SHORT Information about substantial alerts or warnings (including allergies) that health professionals should be aware of. The root of the sections that make up the composition.
Short | Alert SectionComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
236. Composition.section:sectionAlert.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
238. Composition.section:sectionAlert.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
240. Composition.section:sectionAlert.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
242. Composition.section:sectionAlert.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "104605-1" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
244. Composition.section:sectionAlert.entry
Definition | EPS Alerts entry slice A reference to the actual resource from which the narrative in the section is derived.
Short | EPS Alerts entryA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Flag, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
246. Composition.section:sectionAlert.entry:flag
Slice Name | flag
Definition | Contains alert information to be communicated. May optionally reference other resources in IPS.lags A reference to the actual resource from which the narrative in the section is derived.
Short | Alert informationA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Flag:Patient (EU core), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
248. Composition.section:sectionPatientHx
Slice Name | sectionPatientHx
Definition | This section may provide both synthetic anamnesis ,e.g. description of phases of the pathology as a chronological summary of clustered clinical information, and anecdotal evidence that clinicians can collect from the patient, and can read in a narrative form. The root of the sections that make up the composition.
Short | Hx general Reported SectionComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
250. Composition.section:sectionPatientHx.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
252. Composition.section:sectionPatientHx.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
254. Composition.section:sectionPatientHx.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
256. Composition.section:sectionPatientHx.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11329-0" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
258. Composition.section:sectionProblems
Slice Name | sectionProblems
Definition | The Problem List Section lists and describes clinical problems or conditions currently being monitored for the patient. The root of the sections that make up the composition.
Short | Problem List SectionComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
260. Composition.section:sectionProblems.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
262. Composition.section:sectionProblems.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
264. Composition.section:sectionProblems.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
266. Composition.section:sectionProblems.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11450-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
268. Composition.section:sectionProblems.entry
Definition | It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known. A reference to the actual resource from which the narrative in the section is derived.
Short | Clinical problems or conditions currently being monitored for the patient.A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Condition, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
270. Composition.section:sectionProblems.entry:problem
Slice Name | problem
Definition | It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known. A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Condition (EU core), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
272. Composition.section:sectionImmunizations
Slice Name | sectionImmunizations
Definition | The Immunizations Section defines a patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. The section includes the current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized. The root of the sections that make up the composition.
Short | Immunizations SectionComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
274. Composition.section:sectionImmunizations.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
276. Composition.section:sectionImmunizations.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
278. Composition.section:sectionImmunizations.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
280. Composition.section:sectionImmunizations.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11369-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
282. Composition.section:sectionImmunizations.entry
Definition | It defines the patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. It may contain the entire immunization history that is relevant to the period of time being summarized. This entry shall be used to document that no information about immunizations is available, or that no immunizations are known. A reference to the actual resource from which the narrative in the section is derived.
Short | Patient's immunization status and pertinent history.A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Immunization, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
284. Composition.section:sectionImmunizations.entry:immunization
Slice Name | immunization
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Immunization (EU core), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
286. Composition.section:sectionDischargeDetails
Slice Name | sectionDischargeDetails
Definition | The hospital discharge status or disposition of the patient having a hospitalization. The root of the sections that make up the composition.
Short | Discharge detailsComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
288. Composition.section:sectionDischargeDetails.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
290. Composition.section:sectionDischargeDetails.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
292. Composition.section:sectionDischargeDetails.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
294. Composition.section:sectionDischargeDetails.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "8650-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
296. Composition.section:sectionAttachments
Slice Name | sectionAttachments
Definition | This section lists documents and attachments associated to this report The root of the sections that make up the composition.
Short | AttachmentsComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
298. Composition.section:sectionAttachments.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
300. Composition.section:sectionAttachments.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
302. Composition.section:sectionAttachments.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
304. Composition.section:sectionAttachments.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "77599-9" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
306. Composition.section:sectionAttachments.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(DocumentReference, Binary, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be foundhere

0. Composition
Definition | Hospital Discharge Report composition. A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained.
Short | Hospital Discharge Report composition
Invariants | text-or-section: A Composition SHALL have either text, at least one section, or both. (`text.exists() or section.exists()`)
2. Composition.extension
Slicing | This element introduces a set of slices on `Composition.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
4. Composition.extension:basedOn
Slice Name | basedOn
Control | 0..*
Type | Extension(Based on) (Extension Type: Reference(Resource))
6. Composition.extension:basedOn.value[x]
Type | Reference(Resource, ServiceRequest)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
8. Composition.extension:version
Slice Name | version
Short | Business version
Control | 0..1
Type | Extension(Cross-version Extension for R5.Composition.version for use in FHIR R4) (Extension Type: string)
10. Composition.extension:information-recipient
Slice Name | information-recipient
Control | 0..*
Type | Extension(Composition: Information recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization, CareTeam, Group))
12. Composition.extension:information-recipient.value[x]
Type | Reference(PractitionerRole (EU core), Practitioner (EU core), Device, Patient (EU core), RelatedPerson, Organization (EU core))
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
14. Composition.identifier
Short | HDR business identifier
Note | This is a business identifier, not a resource identifier (see discussion)
16. Composition.status
Short | HDR status
18. Composition.type
Definition | Specifies that this composition refer to a Hospital Discharge Report
Short | Kind of composition ("Hospital Discharge Report")
Type | CodeableConcept(Codeable Concept (IPS))
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "34105-7", "display" : "Hospital Discharge summary" }] }`
20. Composition.subject
Definition | Who or what the composition is about. In general a composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure). For the hdr the subject is always the patient.
Control | 1..?
Type | Reference(Patient (EU core))
22. Composition.encounter
Type | Reference(Encounter (HDR))
24. Composition.date
Short | HDR date
26. Composition.author
Definition | Identifies who is responsible for the information in the Hospital Discharge Report, not necessarily who typed it in.
Short | Who and/or what authored the Hospital Discharge Report
Type | Reference(Practitioner (EU core), PractitionerRole (EU core), Device, Organization (EU core))
28. Composition.title
Definition | Official human-readable label for the composition. For this document should be "Hospital Discharge Report" or any equivalent translation
Short | Hospital Discharge Report
30. Composition.attester
32. Composition.attester.mode
Short | The type of attestation
34. Composition.attester.time
Short | When the composition was attested.
36. Composition.attester.party
Short | Who attested the composition.
Type | Reference(Practitioner (EU core), PractitionerRole (EU core), Organization (EU core))
38. Composition.section
Definition | The root of the sections that make up the HDR composition.
Short | Sections composing the HDR
Control | 1..?
Slicing | This element introduces a set of slices on `Composition.section`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ code
40. Composition.section.extension
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
42. Composition.section.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
44. Composition.section.title
Control | 1..?
46. Composition.section.code
Control | 1..?
Type | CodeableConcept(Codeable Concept (IPS))
48. Composition.section:sectionAdmissionEvaluation
Slice Name | sectionAdmissionEvaluation
Definition | Hospital Admission evaluation
Short | Hospital Admission evaluation
Comments | Admission evaluation should be reported only exceptionally, if it is relevant to ensure continuity of care.
Control | 0..1
50. Composition.section:sectionAdmissionEvaluation.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
52. Composition.section:sectionAdmissionEvaluation.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "67851-6" }] }`
54. Composition.section:sectionVitalSigns
Slice Name | sectionVitalSigns
Definition | The Vital signs section includes blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included
Short | Vital signs
Control | 0..1
56. Composition.section:sectionVitalSigns.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
58. Composition.section:sectionVitalSigns.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "8716-3" }] }`
60. Composition.section:sectionVitalSigns.entry
Type | Reference(Observation, DocumentReference, Vital Signs Profile)
62. Composition.section:sectionPhysicalFindings
Slice Name | sectionPhysicalFindings
Definition | Physical findings
Short | Physical findings
Control | 0..1
64. Composition.section:sectionPhysicalFindings.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
66. Composition.section:sectionPhysicalFindings.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "29545-1" }] }`
68. Composition.section:sectionFunctionalStatus
Slice Name | sectionFunctionalStatus
Definition | The functional status section shall contain a narrative description of capability of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide.
Short | Functional status
Control | 0..1
70. Composition.section:sectionFunctionalStatus.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
72. Composition.section:sectionFunctionalStatus.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "47420-5" }] }`
74. Composition.section:sectionFunctionalStatus.entry
Definition | It describes capabilities of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide.
Short | Optional entry used to represent disabilities and functional assessments
Type | Reference(Condition, ClinicalImpression, Observation, DocumentReference, QuestionnaireResponse)
76. Composition.section:sectionHospitalCourse
Slice Name | sectionHospitalCourse
Definition | This section includes basic information about hospital staty (encounter), diagnostic summary in narrative form, pharmacotherapy, major procedures, medical devices, significant findings during hospital stay and clinical synthesis.
Short | Significant information about course of hospital stay
Control | 1..1
78. Composition.section:sectionHospitalCourse.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
80. Composition.section:sectionHospitalCourse.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "8648-8" }] }`
82. Composition.section:sectionDiagnosticSummary
Slice Name | sectionDiagnosticSummary
Definition | All problems/diagnoses that affect care during the inpatient case or are important to be recorded to ensure continuity of care. The diagnostic summary differentiates, in accordance with the international recommendation, between problems treated during hospital stay and other (untreated) problems. Treated problems are problems that were the subject of diagnostics, therapy, nursing, or (continuous) monitoring during the hospitalisation. Furthermore problems could be divided into three categories: problems present on admission (POA), conditions acquired during hospital stay (HAC) and problems that cannot be classified as being of any of the two (N/A). The diagnostic summary contains all conditions as they were recognised at the end of hospitalisation, after all examinations. This section contains concise, well specified, codeable, summary of problems. Problems are ordered by importance (main problems first) during hospital stay. Description of the problem might be completed with additional details in the medical history section and/or in the Synthesis section.
Short | Problem specification in narrative form
Control | 0..1
84. Composition.section:sectionDiagnosticSummary.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
86. Composition.section:sectionDiagnosticSummary.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11535-2" }] }`
88. Composition.section:sectionDiagnosticSummary.entry
Type | Reference(Condition (EU core))
90. Composition.section:sectionSignificantProcedures
Slice Name | sectionSignificantProcedures
Definition | Significant surgical and non-surgical procedures performed during hospitalisation which are significant for continuity of care, e.g. surgeries and other "instrumental"interventions (endoscopic, intravascular), chemotherapy, radiotherapy, purification methods (dialysis, hemoperfusion), circulation support methods (counterpulsation, etc.), administration of blood derivatives or others. This section does not include purely diagnostic procedures (MRI, CT, etc.). If no significant performance has been performed, this fact must be explicitly stated using the IPS Absent and Unknown Data.
Short | Significant procedures
Control | 0..1
92. Composition.section:sectionSignificantProcedures.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
94. Composition.section:sectionSignificantProcedures.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "10185-7" }] }`
96. Composition.section:sectionSignificantProcedures.entry
Type | Reference(Procedure (EU core))
98. Composition.section:sectionSignificantProcedures.section
Control | 0..0
100. Composition.section:sectionMedicalDevices
Slice Name | sectionMedicalDevices
Definition | Implants and used medical devices that affected or may affect the provision of health services (diagnosis and treatment). Also medical devices explanted, or its use was stopped during hospitalisation. If the section is blank, the reason must be explicitly stated using the IPS Absent and Unknown Data coding system.
Short | Medical devices and implants
Control | 0..1
102. Composition.section:sectionMedicalDevices.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
104. Composition.section:sectionMedicalDevices.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "57080-4" }] }`
106. Composition.section:sectionMedicalDevices.entry
Type | Reference(DeviceUseStatement (HDR), Procedure (EU core))
108. Composition.section:sectionMedicalDevices.section
Control | 0..0
110. Composition.section:sectionPharmacotherapy
Slice Name | sectionPharmacotherapy
Definition | Selected drug treatment during hospitalisation. Medicinal products that were administered during hospitalisation and whose administration has already been discontinued before discharge. Only products which are important for continuity of care (antibiotics other than completely routine, corticosteroids in high doses, etc.) will be listed. Products which administration will continue after discharge will be also recorder in the Medication summary section. Medicinal products, the administration of which was started during hospitalisation but is also recommended after discharge, will be listed in the summary table in the recommendation section.
Short | Pharmacotherapy
Control | 0..1
112. Composition.section:sectionPharmacotherapy.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
114. Composition.section:sectionPharmacotherapy.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "87232-5" }] }`
116. Composition.section:sectionPharmacotherapy.entry
Type | Reference(MedicationStatement (EU core), MedicationRequest (HDR), MedicationDispense (HDR), MedicationAdministration (HDR))
118. Composition.section:sectionSignificantResults
Slice Name | sectionSignificantResults
Definition | Significant medical test results of functional, diagnostic (including laboratory), and imaging examinations performed during encounter. This may include orders for which the results have not yet arrived.
Short | Significant medical test results
Control | 0..1
120. Composition.section:sectionSignificantResults.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
122. Composition.section:sectionSignificantResults.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "30954-2" }] }`
124. Composition.section:sectionSignificantResults.entry
Definition | Significant medical test results slice
Short | Significant medical test results
Type | Reference(Observation, DiagnosticReport, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
126. Composition.section:sectionSignificantResults.entry:results-medicalTestResult
Slice Name | results-medicalTestResult
Definition | Results collected on the patient or produced on in-vitro biologic specimens.
Short | Medical test results
Control | 0..*
Type | Reference(Observation: Medical Test Result (EU core))
128. Composition.section:sectionSignificantResults.entry:results-diagnosticReport
Slice Name | results-diagnosticReport
Definition | DiagnosticReport resource to represent diagnostic test and procedure reports in a patient summary
Short | DiagnosticReport
Control | 0..*
Type | Reference(DiagnosticReport (EU core))
130. Composition.section:sectionSynthesis
Slice Name | sectionSynthesis
Definition | This section provides clinical synthesis (e.g. description of reasons and course of hospital stay) clustered by managed conditions. Clinical synthesis may include clinical reasoning (differential diagnostics, explanation of clinical context) in clinically complex conditions.
Short | Synthesis
Control | 0..1
132. Composition.section:sectionSynthesis.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
134. Composition.section:sectionSynthesis.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "67781-5" }] }`
136. Composition.section:sectionPlanOfCare
Slice Name | sectionPlanOfCare
Definition | The plan of care section contains a narrative description of the expectations for care including proposals, goals, and order requests for monitoring, tracking, or improving the condition of the patient.
Short | Plan of Care Section
Control | 0..1
138. Composition.section:sectionPlanOfCare.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
140. Composition.section:sectionPlanOfCare.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "18776-5" }] }`
142. Composition.section:sectionPlanOfCare.entry
Type | Reference(Care Plan (HDR), DocumentReference)
144. Composition.section:sectionDischargeInstructions
Slice Name | sectionDischargeInstructions
Definition | Hospital Discharge Instructions
Short | Hospital Discharge Instructions
Control | 0..1
146. Composition.section:sectionDischargeInstructions.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
148. Composition.section:sectionDischargeInstructions.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "8653-8" }] }`
150. Composition.section:sectionDischargeMedications
Slice Name | sectionDischargeMedications
Definition | Hospital discharge medications defines the medications that the patient is intended to take, or stop, after discharge
Short | Hospital discharge medications
Control | 0..1
152. Composition.section:sectionDischargeMedications.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
154. Composition.section:sectionDischargeMedications.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "75311-1" }] }`
156. Composition.section:sectionDischargeMedications.entry
Type | Reference(MedicationRequest (HDR), MedicationDispense (HDR), MedicationStatement (EU core))
158. Composition.section:sectionAllergies
Slice Name | sectionAllergies
Definition | This section documents the relevant allergies or intolerances for that patient, describing the kind of reaction - e.g. rash, anaphylaxis,.. - preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. If no information about allergies is available, or if no allergies are known this should be clearly documented in the section.
Short | Allergies and Intolerances Section
Control | 0..1
160. Composition.section:sectionAllergies.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
162. Composition.section:sectionAllergies.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48765-2" }] }`
164. Composition.section:sectionAllergies.entry
Definition | allergyOrIntolerance
Short | allergyOrIntolerance
Type | Reference(AllergyIntolerance, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
166. Composition.section:sectionAllergies.entry:allergyOrIntolerance
Slice Name | allergyOrIntolerance
Definition | It lists the relevant allergies or intolerances for that patient, describing the kind of reaction - e.g. rash, anaphylaxis,.. - preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. If no information about allergies is available, or if no allergies are known this should be clearly documented in the section.
Short | Relevant allergies or intolerances for that patient.
Control | 0..*
Type | Reference(AllergyIntolerance (EU core))
168. Composition.section:sectionAlert
Slice Name | sectionAlert
Definition | // SHORT Information about substantial alerts or warnings (including allergies) that health professionals should be aware of.
Short | Alert Section
Control | 0..1
170. Composition.section:sectionAlert.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
172. Composition.section:sectionAlert.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "104605-1" }] }`
174. Composition.section:sectionAlert.entry
Definition | EPS Alerts entry slice
Short | EPS Alerts entry
Type | Reference(Flag, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
176. Composition.section:sectionAlert.entry:flag
Slice Name | flag
Definition | Contains alert information to be communicated. May optionally reference other resources in IPS.lags
Short | Alert information
Control | 0..*
Type | Reference(Flag:Patient (EU core))
178. Composition.section:sectionPatientHx
Slice Name | sectionPatientHx
Definition | This section may provide both synthetic anamnesis ,e.g. description of phases of the pathology as a chronological summary of clustered clinical information, and anecdotal evidence that clinicians can collect from the patient, and can read in a narrative form.
Short | Hx general Reported Section
Control | 0..1
180. Composition.section:sectionPatientHx.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
182. Composition.section:sectionPatientHx.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11329-0" }] }`
184. Composition.section:sectionProblems
Slice Name | sectionProblems
Definition | The Problem List Section lists and describes clinical problems or conditions currently being monitored for the patient.
Short | Problem List Section
Control | 0..1
186. Composition.section:sectionProblems.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
188. Composition.section:sectionProblems.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11450-4" }] }`
190. Composition.section:sectionProblems.entry
Definition | It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known.
Short | Clinical problems or conditions currently being monitored for the patient.
Type | Reference(Condition, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
192. Composition.section:sectionProblems.entry:problem
Slice Name | problem
Definition | It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known.
Control | 0..*
Type | Reference(Condition (EU core))
194. Composition.section:sectionImmunizations
Slice Name | sectionImmunizations
Definition | The Immunizations Section defines a patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. The section includes the current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized.
Short | Immunizations Section
Control | 0..1
196. Composition.section:sectionImmunizations.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
198. Composition.section:sectionImmunizations.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11369-6" }] }`
200. Composition.section:sectionImmunizations.entry
Definition | It defines the patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. It may contain the entire immunization history that is relevant to the period of time being summarized. This entry shall be used to document that no information about immunizations is available, or that no immunizations are known.
Short | Patient's immunization status and pertinent history.
Type | Reference(Immunization, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
202. Composition.section:sectionImmunizations.entry:immunization
Slice Name | immunization
Control | 0..*
Type | Reference(Immunization (EU core))
204. Composition.section:sectionDischargeDetails
Slice Name | sectionDischargeDetails
Definition | The hospital discharge status or disposition of the patient having a hospitalization.
Short | Discharge details
Control | 0..1
206. Composition.section:sectionDischargeDetails.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
208. Composition.section:sectionDischargeDetails.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "8650-4" }] }`
210. Composition.section:sectionAttachments
Slice Name | sectionAttachments
Definition | This section lists documents and attachments associated to this report
Short | Attachments
Control | 0..1
212. Composition.section:sectionAttachments.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
214. Composition.section:sectionAttachments.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "77599-9" }] }`
216. Composition.section:sectionAttachments.entry
Type | Reference(DocumentReference, Binary)

Guidance on how to interpret the contents of this table can be foundhere

0. Composition
Definition | Hospital Discharge Report composition. A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained.
Short | Hospital Discharge Report composition
Comments | While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.
Control | 0..*
Is Modifier | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (`contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (`contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`) text-or-section: A Composition SHALL have either text, at least one section, or both. (`text.exists() or section.exists()`)
2. Composition.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. Composition.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. Composition.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. Composition.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. Composition.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. Composition.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. Composition.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. Composition.extension:basedOn
Slice Name | basedOn
Definition | A plan, proposal or order that is fulfilled in whole or in part by this event.
Short | Fulfills plan, proposal or order
Control | 0..*
Type | Extension(Based on) (Extension Type: Reference(Resource))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. Composition.extension:basedOn.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1 This element is affected by the following invariants: ele-1
Type | id
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
20. Composition.extension:basedOn.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
22. Composition.extension:basedOn.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/StructureDefinition/event-basedOn`
24. Composition.extension:basedOn.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1 This element is affected by the following invariants: ext-1
Type | Reference(Resource, ServiceRequest)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. Composition.extension:version
Slice Name | version
Definition | This cross-version extension represents Composition.version from http://hl7.org/fhir/StructureDefinition/Composition|5.0.0 for use in FHIR R4.
Short | Business version
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Cross-version Extension for R5.Composition.version for use in FHIR R4) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
28. Composition.extension:information-recipient
Slice Name | information-recipient
Definition | This extension applies to the Composition resource and is used to represent an intended recipient of the composition.
Short | Composition: Information recipient
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Composition: Information recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization, CareTeam, Group))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
30. Composition.extension:information-recipient.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
32. Composition.extension:information-recipient.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
34. Composition.extension:information-recipient.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.eu/fhir/StructureDefinition/information-recipient`
36. Composition.extension:information-recipient.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..1
Type | Reference(PractitionerRole (EU core), Practitioner (EU core), Device, Patient (EU core), RelatedPerson, Organization (EU core))
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
38. Composition.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
40. Composition.identifier
Definition | A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.
Short | HDR business identifier
Comments | Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. Composition.status
Definition | The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.
Short | HDR status
Comments | If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements. Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.
Control | 1..1
Binding | The codes SHALL be taken from CompositionStatus (required to `http://hl7.org/fhir/ValueSet/composition-status|4.0.1` ) The workflow/clinical status of the composition.
Type | code
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be able to mark interim, amended, or withdrawn compositions or documents.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. Composition.type
Definition | Specifies that this composition refer to a Hospital Discharge Report
Short | Kind of composition ("Hospital Discharge Report")
Comments | For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.
Control | 1..1
Binding | The codes SHOULD be taken from FHIRDocumentTypeCodes (preferred to `http://hl7.org/fhir/ValueSet/doc-typecodes|4.0.1` ) Type of a composition.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | true
Requirements | Key metadata element describing the composition, used in searching/filtering.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "34105-7", "display" : "Hospital Discharge summary" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. Composition.category
Definition | A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.
Short | Categorization of Composition
Comments | This is a metadata field from XDS/MHD.
Control | 0..*
Binding | For example codes, see DocumentClassValueSet (example to `http://hl7.org/fhir/ValueSet/document-classcodes|4.0.1` ) High-level kind of a clinical document at a macro level.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. Composition.subject
Definition | Who or what the composition is about. In general a composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure). For the hdr the subject is always the patient.
Short | Who and/or what the composition is about
Comments | For clinical documents, this is usually the patient.
Control | 1..1
Type | Reference(Patient (EU core))
Is Modifier | false
Summary | true
Requirements | Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. Composition.encounter
Definition | Describes the clinical encounter or type of care this documentation is associated with.
Short | Context of the Composition
Control | 0..1
Type | Reference(Encounter (HDR))
Is Modifier | false
Summary | true
Requirements | Provides context for the composition and supports searching.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. Composition.date
Definition | The composition editing time, when the composition was last logically changed by the author.
Short | HDR date
Comments | The Last Modified Date on the composition may be after the date of the document was attested without being changed.
Control | 1..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. Composition.author
Definition | Identifies who is responsible for the information in the Hospital Discharge Report, not necessarily who typed it in.
Short | Who and/or what authored the Hospital Discharge Report
Control | 1..*
Type | Reference(Practitioner (EU core), PractitionerRole (EU core), Device, Organization (EU core))
Is Modifier | false
Summary | true
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. Composition.title
Definition | Official human-readable label for the composition. For this document should be "Hospital Discharge Report" or any equivalent translation
Short | Hospital Discharge Report
Comments | For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. Composition.confidentiality
Definition | The code specifying the level of confidentiality of the Composition.
Short | As defined by affinity domain
Comments | The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.
Control | 0..1
Binding | The codes SHALL be taken from v3.ConfidentialityClassification (2014-03-26) (required to `http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26` ) Codes specifying the level of confidentiality of the composition.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. Composition.attester
Definition | A participant who has attested to the accuracy of the composition/document.
Short | Attests to accuracy of composition
Comments | Only list each attester once.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Identifies responsibility for the accuracy of the composition content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. Composition.attester.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
64. Composition.attester.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
66. Composition.attester.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
68. Composition.attester.mode
Definition | The type of attestation the authenticator offers.
Short | The type of attestation
Control | 1..1
Binding | The codes SHALL be taken from CompositionAttestationMode (required to `http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1` ) The way in which a person authenticated a composition.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Indicates the level of authority of the attestation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. Composition.attester.time
Definition | When the composition was attested by the party.
Short | When the composition was attested.
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. Composition.attester.party
Definition | Who attested the composition in the specified way.
Short | Who attested the composition.
Control | 0..1
Type | Reference(Practitioner (EU core), PractitionerRole (EU core), Organization (EU core))
Is Modifier | false
Summary | false
Requirements | Identifies who has taken on the responsibility for accuracy of the composition content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. Composition.custodian
Definition | Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.
Short | Organization which maintains the composition
Comments | This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Requirements | Identifies where to go to find the current version, where to report issues, etc.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. Composition.relatesTo
Definition | Relationships that this composition has with other compositions or documents that already exist.
Short | Relationships to other compositions/documents
Comments | A document is a version specific composition.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. Composition.relatesTo.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
80. Composition.relatesTo.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
82. Composition.relatesTo.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
84. Composition.relatesTo.code
Definition | The type of relationship that this composition has with anther composition or document.
Short | replaces | transforms | signs | appends
Comments | If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.
Control | 1..1
Binding | The codes SHALL be taken from DocumentRelationshipType (required to `http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1` ) The type of relationship between documents.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. Composition.relatesTo.target[x]
Definition | The target composition/document of this relationship.
Short | Target of the relationship
Control | 1..1
Type | Choice of: Identifier, Reference(Composition)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
88. Composition.event
Definition | The clinical service, such as a colonoscopy or an appendectomy, being documented.
Short | The clinical service(s) being documented
Comments | The event needs to be consistent with the type element, though can provide further information if desired.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
90. Composition.event.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
92. Composition.event.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
94. Composition.event.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
96. Composition.event.code
Definition | This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.
Short | Code(s) that apply to the event being documented
Comments | An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.
Control | 0..*
Binding | For example codes, see v3 Code System ActCode (example to `http://terminology.hl7.org/ValueSet/v3-ActCode` ) This list of codes represents the main clinical acts being documented.
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
98. Composition.event.period
Definition | The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.
Short | The period covered by the documentation
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. Composition.event.detail
Definition | The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.
Short | The event(s) being documented
Control | 0..*
Type | Reference(Resource)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
102. Composition.section
Definition | The root of the sections that make up the HDR composition.
Short | Sections composing the HDR
Control | 1..*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ code
104. Composition.section.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
106. Composition.section.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
108. Composition.section.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
110. Composition.section.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
112. Composition.section.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
114. Composition.section.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
116. Composition.section.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
118. Composition.section.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
120. Composition.section.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
122. Composition.section.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
124. Composition.section.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
126. Composition.section.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
128. Composition.section.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
130. Composition.section.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
132. Composition.section:sectionAdmissionEvaluation
Slice Name | sectionAdmissionEvaluation
Definition | Hospital Admission evaluation
Short | Hospital Admission evaluation
Comments | Admission evaluation should be reported only exceptionally, if it is relevant to ensure continuity of care.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
134. Composition.section:sectionAdmissionEvaluation.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
136. Composition.section:sectionAdmissionEvaluation.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
138. Composition.section:sectionAdmissionEvaluation.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
140. Composition.section:sectionAdmissionEvaluation.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
142. Composition.section:sectionAdmissionEvaluation.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
144. Composition.section:sectionAdmissionEvaluation.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "67851-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
146. Composition.section:sectionAdmissionEvaluation.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
148. Composition.section:sectionAdmissionEvaluation.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
150. Composition.section:sectionAdmissionEvaluation.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
152. Composition.section:sectionAdmissionEvaluation.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
154. Composition.section:sectionAdmissionEvaluation.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
156. Composition.section:sectionAdmissionEvaluation.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
158. Composition.section:sectionAdmissionEvaluation.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
160. Composition.section:sectionAdmissionEvaluation.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
162. Composition.section:sectionVitalSigns
Slice Name | sectionVitalSigns
Definition | The Vital signs section includes blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included
Short | Vital signs
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
164. Composition.section:sectionVitalSigns.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
166. Composition.section:sectionVitalSigns.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
168. Composition.section:sectionVitalSigns.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
170. Composition.section:sectionVitalSigns.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
172. Composition.section:sectionVitalSigns.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
174. Composition.section:sectionVitalSigns.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "8716-3" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
176. Composition.section:sectionVitalSigns.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
178. Composition.section:sectionVitalSigns.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
180. Composition.section:sectionVitalSigns.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
182. Composition.section:sectionVitalSigns.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
184. Composition.section:sectionVitalSigns.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
186. Composition.section:sectionVitalSigns.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation, DocumentReference, Vital Signs Profile)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
188. Composition.section:sectionVitalSigns.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
190. Composition.section:sectionVitalSigns.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
192. Composition.section:sectionPhysicalFindings
Slice Name | sectionPhysicalFindings
Definition | Physical findings
Short | Physical findings
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
194. Composition.section:sectionPhysicalFindings.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
196. Composition.section:sectionPhysicalFindings.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
198. Composition.section:sectionPhysicalFindings.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
200. Composition.section:sectionPhysicalFindings.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
202. Composition.section:sectionPhysicalFindings.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
204. Composition.section:sectionPhysicalFindings.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "29545-1" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
206. Composition.section:sectionPhysicalFindings.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
208. Composition.section:sectionPhysicalFindings.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
210. Composition.section:sectionPhysicalFindings.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
212. Composition.section:sectionPhysicalFindings.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
214. Composition.section:sectionPhysicalFindings.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
216. Composition.section:sectionPhysicalFindings.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
218. Composition.section:sectionPhysicalFindings.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
220. Composition.section:sectionPhysicalFindings.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
222. Composition.section:sectionFunctionalStatus
Slice Name | sectionFunctionalStatus
Definition | The functional status section shall contain a narrative description of capability of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide.
Short | Functional status
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
224. Composition.section:sectionFunctionalStatus.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
226. Composition.section:sectionFunctionalStatus.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
228. Composition.section:sectionFunctionalStatus.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
230. Composition.section:sectionFunctionalStatus.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
232. Composition.section:sectionFunctionalStatus.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
234. Composition.section:sectionFunctionalStatus.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "47420-5" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
236. Composition.section:sectionFunctionalStatus.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
238. Composition.section:sectionFunctionalStatus.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
240. Composition.section:sectionFunctionalStatus.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
242. Composition.section:sectionFunctionalStatus.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
244. Composition.section:sectionFunctionalStatus.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
246. Composition.section:sectionFunctionalStatus.entry
Definition | It describes capabilities of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide.
Short | Optional entry used to represent disabilities and functional assessments
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Condition, ClinicalImpression, Observation, DocumentReference, QuestionnaireResponse)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
248. Composition.section:sectionFunctionalStatus.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
250. Composition.section:sectionFunctionalStatus.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
252. Composition.section:sectionHospitalCourse
Slice Name | sectionHospitalCourse
Definition | This section includes basic information about hospital staty (encounter), diagnostic summary in narrative form, pharmacotherapy, major procedures, medical devices, significant findings during hospital stay and clinical synthesis.
Short | Significant information about course of hospital stay
Control | 1..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
254. Composition.section:sectionHospitalCourse.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
256. Composition.section:sectionHospitalCourse.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
258. Composition.section:sectionHospitalCourse.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
260. Composition.section:sectionHospitalCourse.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
262. Composition.section:sectionHospitalCourse.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
264. Composition.section:sectionHospitalCourse.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "8648-8" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
266. Composition.section:sectionHospitalCourse.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
268. Composition.section:sectionHospitalCourse.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
270. Composition.section:sectionHospitalCourse.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
272. Composition.section:sectionHospitalCourse.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
274. Composition.section:sectionHospitalCourse.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
276. Composition.section:sectionHospitalCourse.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
278. Composition.section:sectionHospitalCourse.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
280. Composition.section:sectionHospitalCourse.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
282. Composition.section:sectionDiagnosticSummary
Slice Name | sectionDiagnosticSummary
Definition | All problems/diagnoses that affect care during the inpatient case or are important to be recorded to ensure continuity of care. The diagnostic summary differentiates, in accordance with the international recommendation, between problems treated during hospital stay and other (untreated) problems. Treated problems are problems that were the subject of diagnostics, therapy, nursing, or (continuous) monitoring during the hospitalisation. Furthermore problems could be divided into three categories: problems present on admission (POA), conditions acquired during hospital stay (HAC) and problems that cannot be classified as being of any of the two (N/A). The diagnostic summary contains all conditions as they were recognised at the end of hospitalisation, after all examinations. This section contains concise, well specified, codeable, summary of problems. Problems are ordered by importance (main problems first) during hospital stay. Description of the problem might be completed with additional details in the medical history section and/or in the Synthesis section.
Short | Problem specification in narrative form
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
284. Composition.section:sectionDiagnosticSummary.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
286. Composition.section:sectionDiagnosticSummary.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
288. Composition.section:sectionDiagnosticSummary.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
290. Composition.section:sectionDiagnosticSummary.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
292. Composition.section:sectionDiagnosticSummary.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
294. Composition.section:sectionDiagnosticSummary.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11535-2" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
296. Composition.section:sectionDiagnosticSummary.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
298. Composition.section:sectionDiagnosticSummary.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
300. Composition.section:sectionDiagnosticSummary.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
302. Composition.section:sectionDiagnosticSummary.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
304. Composition.section:sectionDiagnosticSummary.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
306. Composition.section:sectionDiagnosticSummary.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Condition (EU core))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
308. Composition.section:sectionDiagnosticSummary.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
310. Composition.section:sectionDiagnosticSummary.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
312. Composition.section:sectionSignificantProcedures
Slice Name | sectionSignificantProcedures
Definition | Significant surgical and non-surgical procedures performed during hospitalisation which are significant for continuity of care, e.g. surgeries and other "instrumental"interventions (endoscopic, intravascular), chemotherapy, radiotherapy, purification methods (dialysis, hemoperfusion), circulation support methods (counterpulsation, etc.), administration of blood derivatives or others. This section does not include purely diagnostic procedures (MRI, CT, etc.). If no significant performance has been performed, this fact must be explicitly stated using the IPS Absent and Unknown Data.
Short | Significant procedures
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
314. Composition.section:sectionSignificantProcedures.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
316. Composition.section:sectionSignificantProcedures.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
318. Composition.section:sectionSignificantProcedures.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
320. Composition.section:sectionSignificantProcedures.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
322. Composition.section:sectionSignificantProcedures.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
324. Composition.section:sectionSignificantProcedures.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "10185-7" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
326. Composition.section:sectionSignificantProcedures.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
328. Composition.section:sectionSignificantProcedures.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
330. Composition.section:sectionSignificantProcedures.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
332. Composition.section:sectionSignificantProcedures.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
334. Composition.section:sectionSignificantProcedures.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
336. Composition.section:sectionSignificantProcedures.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Procedure (EU core))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
338. Composition.section:sectionSignificantProcedures.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
340. Composition.section:sectionSignificantProcedures.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
342. Composition.section:sectionMedicalDevices
Slice Name | sectionMedicalDevices
Definition | Implants and used medical devices that affected or may affect the provision of health services (diagnosis and treatment). Also medical devices explanted, or its use was stopped during hospitalisation. If the section is blank, the reason must be explicitly stated using the IPS Absent and Unknown Data coding system.
Short | Medical devices and implants
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
344. Composition.section:sectionMedicalDevices.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
346. Composition.section:sectionMedicalDevices.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
348. Composition.section:sectionMedicalDevices.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
350. Composition.section:sectionMedicalDevices.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
352. Composition.section:sectionMedicalDevices.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
354. Composition.section:sectionMedicalDevices.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "57080-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
356. Composition.section:sectionMedicalDevices.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
358. Composition.section:sectionMedicalDevices.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
360. Composition.section:sectionMedicalDevices.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
362. Composition.section:sectionMedicalDevices.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
364. Composition.section:sectionMedicalDevices.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
366. Composition.section:sectionMedicalDevices.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(DeviceUseStatement (HDR), Procedure (EU core))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
368. Composition.section:sectionMedicalDevices.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
370. Composition.section:sectionMedicalDevices.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
372. Composition.section:sectionPharmacotherapy
Slice Name | sectionPharmacotherapy
Definition | Selected drug treatment during hospitalisation. Medicinal products that were administered during hospitalisation and whose administration has already been discontinued before discharge. Only products which are important for continuity of care (antibiotics other than completely routine, corticosteroids in high doses, etc.) will be listed. Products which administration will continue after discharge will be also recorder in the Medication summary section. Medicinal products, the administration of which was started during hospitalisation but is also recommended after discharge, will be listed in the summary table in the recommendation section.
Short | Pharmacotherapy
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
374. Composition.section:sectionPharmacotherapy.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
376. Composition.section:sectionPharmacotherapy.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
378. Composition.section:sectionPharmacotherapy.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
380. Composition.section:sectionPharmacotherapy.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
382. Composition.section:sectionPharmacotherapy.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
384. Composition.section:sectionPharmacotherapy.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "87232-5" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
386. Composition.section:sectionPharmacotherapy.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
388. Composition.section:sectionPharmacotherapy.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
390. Composition.section:sectionPharmacotherapy.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
392. Composition.section:sectionPharmacotherapy.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
394. Composition.section:sectionPharmacotherapy.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
396. Composition.section:sectionPharmacotherapy.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(MedicationStatement (EU core), MedicationRequest (HDR), MedicationDispense (HDR), MedicationAdministration (HDR))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
398. Composition.section:sectionPharmacotherapy.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
400. Composition.section:sectionPharmacotherapy.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
402. Composition.section:sectionSignificantResults
Slice Name | sectionSignificantResults
Definition | Significant medical test results of functional, diagnostic (including laboratory), and imaging examinations performed during encounter. This may include orders for which the results have not yet arrived.
Short | Significant medical test results
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
404. Composition.section:sectionSignificantResults.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
406. Composition.section:sectionSignificantResults.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
408. Composition.section:sectionSignificantResults.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
410. Composition.section:sectionSignificantResults.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
412. Composition.section:sectionSignificantResults.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
414. Composition.section:sectionSignificantResults.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "30954-2" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
416. Composition.section:sectionSignificantResults.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
418. Composition.section:sectionSignificantResults.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
420. Composition.section:sectionSignificantResults.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
422. Composition.section:sectionSignificantResults.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
424. Composition.section:sectionSignificantResults.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
426. Composition.section:sectionSignificantResults.entry
Definition | Significant medical test results slice
Short | Significant medical test results
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation, DiagnosticReport, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
428. Composition.section:sectionSignificantResults.entry:results-medicalTestResult
Slice Name | results-medicalTestResult
Definition | Results collected on the patient or produced on in-vitro biologic specimens.
Short | Medical test results
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation: Medical Test Result (EU core))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
430. Composition.section:sectionSignificantResults.entry:results-diagnosticReport
Slice Name | results-diagnosticReport
Definition | DiagnosticReport resource to represent diagnostic test and procedure reports in a patient summary
Short | DiagnosticReport
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(DiagnosticReport (EU core))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
432. Composition.section:sectionSignificantResults.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
434. Composition.section:sectionSignificantResults.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
436. Composition.section:sectionSynthesis
Slice Name | sectionSynthesis
Definition | This section provides clinical synthesis (e.g. description of reasons and course of hospital stay) clustered by managed conditions. Clinical synthesis may include clinical reasoning (differential diagnostics, explanation of clinical context) in clinically complex conditions.
Short | Synthesis
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
438. Composition.section:sectionSynthesis.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
440. Composition.section:sectionSynthesis.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
442. Composition.section:sectionSynthesis.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
444. Composition.section:sectionSynthesis.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
446. Composition.section:sectionSynthesis.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
448. Composition.section:sectionSynthesis.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "67781-5" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
450. Composition.section:sectionSynthesis.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
452. Composition.section:sectionSynthesis.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
454. Composition.section:sectionSynthesis.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
456. Composition.section:sectionSynthesis.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
458. Composition.section:sectionSynthesis.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
460. Composition.section:sectionSynthesis.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
462. Composition.section:sectionSynthesis.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
464. Composition.section:sectionSynthesis.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
466. Composition.section:sectionPlanOfCare
Slice Name | sectionPlanOfCare
Definition | The plan of care section contains a narrative description of the expectations for care including proposals, goals, and order requests for monitoring, tracking, or improving the condition of the patient.
Short | Plan of Care Section
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
468. Composition.section:sectionPlanOfCare.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
470. Composition.section:sectionPlanOfCare.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
472. Composition.section:sectionPlanOfCare.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
474. Composition.section:sectionPlanOfCare.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
476. Composition.section:sectionPlanOfCare.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
478. Composition.section:sectionPlanOfCare.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "18776-5" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
480. Composition.section:sectionPlanOfCare.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
482. Composition.section:sectionPlanOfCare.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
484. Composition.section:sectionPlanOfCare.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
486. Composition.section:sectionPlanOfCare.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
488. Composition.section:sectionPlanOfCare.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
490. Composition.section:sectionPlanOfCare.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Care Plan (HDR), DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
492. Composition.section:sectionPlanOfCare.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
494. Composition.section:sectionPlanOfCare.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
496. Composition.section:sectionDischargeInstructions
Slice Name | sectionDischargeInstructions
Definition | Hospital Discharge Instructions
Short | Hospital Discharge Instructions
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
498. Composition.section:sectionDischargeInstructions.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
500. Composition.section:sectionDischargeInstructions.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
502. Composition.section:sectionDischargeInstructions.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
504. Composition.section:sectionDischargeInstructions.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
506. Composition.section:sectionDischargeInstructions.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
508. Composition.section:sectionDischargeInstructions.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "8653-8" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
510. Composition.section:sectionDischargeInstructions.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
512. Composition.section:sectionDischargeInstructions.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
514. Composition.section:sectionDischargeInstructions.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
516. Composition.section:sectionDischargeInstructions.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
518. Composition.section:sectionDischargeInstructions.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
520. Composition.section:sectionDischargeInstructions.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
522. Composition.section:sectionDischargeInstructions.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
524. Composition.section:sectionDischargeInstructions.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
526. Composition.section:sectionDischargeMedications
Slice Name | sectionDischargeMedications
Definition | Hospital discharge medications defines the medications that the patient is intended to take, or stop, after discharge
Short | Hospital discharge medications
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
528. Composition.section:sectionDischargeMedications.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
530. Composition.section:sectionDischargeMedications.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
532. Composition.section:sectionDischargeMedications.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
534. Composition.section:sectionDischargeMedications.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
536. Composition.section:sectionDischargeMedications.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
538. Composition.section:sectionDischargeMedications.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "75311-1" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
540. Composition.section:sectionDischargeMedications.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
542. Composition.section:sectionDischargeMedications.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
544. Composition.section:sectionDischargeMedications.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
546. Composition.section:sectionDischargeMedications.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
548. Composition.section:sectionDischargeMedications.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
550. Composition.section:sectionDischargeMedications.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(MedicationRequest (HDR), MedicationDispense (HDR), MedicationStatement (EU core))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
552. Composition.section:sectionDischargeMedications.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
554. Composition.section:sectionDischargeMedications.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
556. Composition.section:sectionAllergies
Slice Name | sectionAllergies
Definition | This section documents the relevant allergies or intolerances for that patient, describing the kind of reaction - e.g. rash, anaphylaxis,.. - preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. If no information about allergies is available, or if no allergies are known this should be clearly documented in the section.
Short | Allergies and Intolerances Section
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
558. Composition.section:sectionAllergies.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
560. Composition.section:sectionAllergies.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
562. Composition.section:sectionAllergies.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
564. Composition.section:sectionAllergies.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
566. Composition.section:sectionAllergies.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
568. Composition.section:sectionAllergies.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48765-2" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
570. Composition.section:sectionAllergies.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
572. Composition.section:sectionAllergies.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
574. Composition.section:sectionAllergies.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
576. Composition.section:sectionAllergies.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
578. Composition.section:sectionAllergies.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
580. Composition.section:sectionAllergies.entry
Definition | allergyOrIntolerance
Short | allergyOrIntolerance
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(AllergyIntolerance, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
582. Composition.section:sectionAllergies.entry:allergyOrIntolerance
Slice Name | allergyOrIntolerance
Definition | It lists the relevant allergies or intolerances for that patient, describing the kind of reaction - e.g. rash, anaphylaxis,.. - preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. If no information about allergies is available, or if no allergies are known this should be clearly documented in the section.
Short | Relevant allergies or intolerances for that patient.
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(AllergyIntolerance (EU core))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
584. Composition.section:sectionAllergies.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
586. Composition.section:sectionAllergies.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
588. Composition.section:sectionAlert
Slice Name | sectionAlert
Definition | // SHORT Information about substantial alerts or warnings (including allergies) that health professionals should be aware of.
Short | Alert Section
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
590. Composition.section:sectionAlert.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
592. Composition.section:sectionAlert.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
594. Composition.section:sectionAlert.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
596. Composition.section:sectionAlert.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
598. Composition.section:sectionAlert.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
600. Composition.section:sectionAlert.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "104605-1" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
602. Composition.section:sectionAlert.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
604. Composition.section:sectionAlert.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
606. Composition.section:sectionAlert.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
608. Composition.section:sectionAlert.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
610. Composition.section:sectionAlert.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
612. Composition.section:sectionAlert.entry
Definition | EPS Alerts entry slice
Short | EPS Alerts entry
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Flag, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
614. Composition.section:sectionAlert.entry:flag
Slice Name | flag
Definition | Contains alert information to be communicated. May optionally reference other resources in IPS.lags
Short | Alert information
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Flag:Patient (EU core))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
616. Composition.section:sectionAlert.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
618. Composition.section:sectionAlert.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
620. Composition.section:sectionPatientHx
Slice Name | sectionPatientHx
Definition | This section may provide both synthetic anamnesis ,e.g. description of phases of the pathology as a chronological summary of clustered clinical information, and anecdotal evidence that clinicians can collect from the patient, and can read in a narrative form.
Short | Hx general Reported Section
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
622. Composition.section:sectionPatientHx.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
624. Composition.section:sectionPatientHx.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
626. Composition.section:sectionPatientHx.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
628. Composition.section:sectionPatientHx.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
630. Composition.section:sectionPatientHx.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
632. Composition.section:sectionPatientHx.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11329-0" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
634. Composition.section:sectionPatientHx.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
636. Composition.section:sectionPatientHx.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
638. Composition.section:sectionPatientHx.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
640. Composition.section:sectionPatientHx.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
642. Composition.section:sectionPatientHx.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
644. Composition.section:sectionPatientHx.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
646. Composition.section:sectionPatientHx.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
648. Composition.section:sectionPatientHx.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
650. Composition.section:sectionProblems
Slice Name | sectionProblems
Definition | The Problem List Section lists and describes clinical problems or conditions currently being monitored for the patient.
Short | Problem List Section
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
652. Composition.section:sectionProblems.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
654. Composition.section:sectionProblems.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
656. Composition.section:sectionProblems.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
658. Composition.section:sectionProblems.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
660. Composition.section:sectionProblems.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
662. Composition.section:sectionProblems.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11450-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
664. Composition.section:sectionProblems.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
666. Composition.section:sectionProblems.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
668. Composition.section:sectionProblems.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
670. Composition.section:sectionProblems.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
672. Composition.section:sectionProblems.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
674. Composition.section:sectionProblems.entry
Definition | It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known.
Short | Clinical problems or conditions currently being monitored for the patient.
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Condition, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
676. Composition.section:sectionProblems.entry:problem
Slice Name | problem
Definition | It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Condition (EU core))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
678. Composition.section:sectionProblems.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
680. Composition.section:sectionProblems.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
682. Composition.section:sectionImmunizations
Slice Name | sectionImmunizations
Definition | The Immunizations Section defines a patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. The section includes the current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized.
Short | Immunizations Section
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
684. Composition.section:sectionImmunizations.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
686. Composition.section:sectionImmunizations.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
688. Composition.section:sectionImmunizations.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
690. Composition.section:sectionImmunizations.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
692. Composition.section:sectionImmunizations.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
694. Composition.section:sectionImmunizations.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11369-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
696. Composition.section:sectionImmunizations.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
698. Composition.section:sectionImmunizations.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
700. Composition.section:sectionImmunizations.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
702. Composition.section:sectionImmunizations.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
704. Composition.section:sectionImmunizations.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
706. Composition.section:sectionImmunizations.entry
Definition | It defines the patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. It may contain the entire immunization history that is relevant to the period of time being summarized. This entry shall be used to document that no information about immunizations is available, or that no immunizations are known.
Short | Patient's immunization status and pertinent history.
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Immunization, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
708. Composition.section:sectionImmunizations.entry:immunization
Slice Name | immunization
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Immunization (EU core))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
710. Composition.section:sectionImmunizations.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
712. Composition.section:sectionImmunizations.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
714. Composition.section:sectionDischargeDetails
Slice Name | sectionDischargeDetails
Definition | The hospital discharge status or disposition of the patient having a hospitalization.
Short | Discharge details
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
716. Composition.section:sectionDischargeDetails.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
718. Composition.section:sectionDischargeDetails.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
720. Composition.section:sectionDischargeDetails.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
722. Composition.section:sectionDischargeDetails.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
724. Composition.section:sectionDischargeDetails.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
726. Composition.section:sectionDischargeDetails.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "8650-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
728. Composition.section:sectionDischargeDetails.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
730. Composition.section:sectionDischargeDetails.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
732. Composition.section:sectionDischargeDetails.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
734. Composition.section:sectionDischargeDetails.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
736. Composition.section:sectionDischargeDetails.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
738. Composition.section:sectionDischargeDetails.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
740. Composition.section:sectionDischargeDetails.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
742. Composition.section:sectionDischargeDetails.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
744. Composition.section:sectionAttachments
Slice Name | sectionAttachments
Definition | This section lists documents and attachments associated to this report
Short | Attachments
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | cmp-1: A section must contain at least one of text, entries, or sub-sections (`text.exists() or entry.exists() or section.exists()`) cmp-2: A section can only have an emptyReason if it is empty (`emptyReason.empty() or entry.empty()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
746. Composition.section:sectionAttachments.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
748. Composition.section:sectionAttachments.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Composition.section.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
750. Composition.section:sectionAttachments.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
752. Composition.section:sectionAttachments.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
754. Composition.section:sectionAttachments.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Short | Label for section (e.g. for ToC)
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
756. Composition.section:sectionAttachments.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification of section (recommended)
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "77599-9" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
758. Composition.section:sectionAttachments.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
760. Composition.section:sectionAttachments.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Short | Who/what the section is about, when it is not about the subject of composition
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
762. Composition.section:sectionAttachments.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
764. Composition.section:sectionAttachments.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The codes SHALL be taken from ListMode (required to `http://hl7.org/fhir/ValueSet/list-mode|4.0.1` ) The processing mode that applies to this section.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
766. Composition.section:sectionAttachments.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order of section entries
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
768. Composition.section:sectionAttachments.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(DocumentReference, Binary)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
770. Composition.section:sectionAttachments.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why the section is empty
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
772. Composition.section:sectionAttachments.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)